Introduction to the Neurological Examination 2 Flashcards
Motor
Inspect at rest with facial expression
Wrinkle the forehead
Tremor
CHorea
Athetosis
Tics
Rhythmic, oscillating movement
Flit-like or dancing like
Writhing
Twitching or jumping
Myoclonus
Ballsim
Fasciulations
Large muscle jerks
Flining of entire limbn
Small twitches underneath skin (LMN dz)
pronator drift
Supinate and weak arm will begin to pronate and drop…suble UMN dysfunction
Leg rolll and leg lift
Roll patient leg and watch foot
Lift leg and heel should reminai n contact
Spasticity
Rigidity
Flaccidity
Tone is greater when passive movement is rapid…initial hypertonia gives way
Increase resistance independent of rate
Loss of muscle tone
Levels of muscles strength
1 - not enough to move but flickers
2 - voluntary but can’t overcome gravity
3 - voluntary good enough fro only gravity
4 - overcomes some resistance
Patterns of UMN, neurpathic
Myopathic, NMJ
Weakness of esntensors of arms and flexors of legs
Distal>prox
Prox>distal
Fluctuating, occubulbar and limbs
Pathologic reflexes of face, hand, and foot
Glabellar
Snout
Grasp
Babinski
Chaddock
Clonus
Rhythmic sustained involutnary contractions evoken by suddne passive stretch of the muscle
More than 5 is abnormla\
Results from UMN lesion that disinihibits the tendon streth reflex
Ankle
Knee
Brachioradialis/Biceps
Trceps
S1
L2,3,4
C5,6
C6,7
Dysdiadochokinesis
Inability to perform rapid alternating movements
Dysmetria
Cannot to point to point movements
Romberg eyes open and closed
Open - cerebellum probelm
Closed - posterior column (removes visual input)
Tandem gait abnormalities
Cerebellar lesion if other things ruled out
